Infectious complications in compound mandibular fractures undergoing a delayed surgical intervention - a prospective...

Area of Science:

• Oral and Maxillofacial Surgery
• Trauma Surgery
• Infectious Disease Control

Background:

• Compound mandibular fractures are complex injuries requiring timely surgical management.
• Postoperative infectious complications, such as surgical site infections (SSI), are a concern following open reduction and internal fixation (ORIF).
• The optimal timing for surgical intervention in open mandibular fractures remains a subject of investigation.

Purpose of the Study:

• To investigate whether a delay in definitive surgical intervention for compound mandibular fractures increases the risk of postoperative infectious complications.
• To analyze the association between the time from injury to ORIF and the incidence of SSI.
• To identify potential risk factors for infectious complications in patients with compound mandibular fractures.

Main Methods:

• Prospective study analyzing 83 patients with compound mandibular fractures undergoing ORIF.
• Delayed intervention was defined as ORIF performed more than 72 hours post-injury.
• Statistical analysis included the Mann-Whitney U test for comparing delayed ORIF with SSI and chi-squared/Fisher's exact tests for risk factor association.

Main Results:

• A median delay of 8 days (range: 4-19) was observed in the delayed ORIF group.
• Eight patients (9.6%) developed SSI, managed with outpatient intervention; two required repeat surgery for non-union.
• No statistically significant association was found between delayed ORIF (median 6.5 days in SSI group) and SSI (p=0.7).
• Univariate analysis did not establish significant relationships between SSI and predetermined risk factors.

Conclusions:

• Delaying definitive surgical intervention for compound mandibular fractures beyond 72 hours was not found to be an independent risk factor for postoperative infectious complications.
• The study suggests that timely surgical intervention may not be critical in preventing SSI for these specific injuries.
• Further research is warranted to explore other contributing factors to infectious complications in mandibular fracture management.